Traumatic brain injury in children: 18 years of management.

Traumatic brain injury in children is a common cause of emergency department admission to our institution. The aim was to summarize the management of all head injuries in children. This was a retrospective, descriptive single center study performed in the Neurosurgery Department, University Hospital Center, Yopougon-Abidjan, Ivory Coast from January 2000 to December 2017. We included all patients less than 16-years-old admitted to the emergency department and all admitted in neurosurgery department for a traumatic brain injury with a cerebral tomodensitometry and/or a magnetic resonance imaging. 292 patients were admitted in neurosurgery department during the study period. The average age of our patients was 7.8 ± 0.80 years with a male predominance (64%). Road accidents were the main causes (78.7%) followed by falls. Brain trauma was mild in 53.8% of cases, moderate in 36.8% and severe in 9.4% of cases. Initial loss of consciousness and headache were the main reasons for admission to the emergency room after the injury with a proportion of 87.6%. The oedemato-haemorrhagic contusion was the most frequent lesion found in our patients with a frequency of 33.9%. The surgery was performed in 36.9% of cases. The overall mortality of patients in the study remains high with a proportion of 13.18%. Traumatic brain injuries in children had a high mortality rate in our practice. Specialized centers should be developed to optimize their care.

[Hydrocephaly resulting from thrombophlebitis of the superior sagittal sinus due to osteitis of the cranial vault caused by Aspergillus fumigatus in an immunocompetent patient]. / Hydrocéphalie sur thrombophlébite du sinus sagittal supérieur par ostéite de la voûte à Aspergillus fumigatus sur terrain immunocompétent.

This case study presents an unusual pathogenic association among several cranioencephalic lesions characterized by the association of osteitis of the cranial vault, due to Aspergillus fumigatus, with underlying thrombophlebitis complicated by intracranial hypertension resulting from hydrocephalus. The study involved a 43-year old HIV (human immunodeficiency virus) negative man with multi-recurrent infection of the frontal scalp. The patient was successfully treated with cerebrospinal fluid diversion (CFD), Ketoconazole and low molecular weight heparin. This study describes the different pathophysiological and therapeutic features of this exceptional pathogenic association.

Les méningiomes intrâcraniens en milieu ivoirien. Étude d/'une serie chirurgicale

Objectif. Presenter les particularites epidemiologiques; cliniques et therapeutiques des meningiomes intracraniens en milieu sous medicalise; a travers l'experience ivoirienne. Materiel et Methode. Il s'agit d'une etude retrospective d'une serie de 96 cas de meningiomes intracraniens traites au service de neurochirurgie d'Abidjan de 1991 a 200 . Le diagnostic pre chirurgical ou avant la biopsie fait par le scanner etait confirme par l'examen neuro-pathologique. Le suivi postoperatoire a ete clinique et quelquefois un examen tomodensitometrique a ete realise.Resultats. Les meningiomes ont represente 33;43des tumeurs intracraniennes. La moyenne d'age au moment du diagnostic etait de 43 ans avec des extremes de 07 a 72 ans. Le sexe feminin a predomine avec un sex-ratio de 3/2. Le tableau clinique etait domine par les cephalees. Le delai precedant le diagnostic etait d'environ 22 mois. Les meningiomes de la convexite etaient les plus frequents (47;36). Dans la majorite des cas le diametre tumoral se situait entre 3 cm et 6 cm. L'exerese chirurgicale a constitue l'essentiel du traitement avec une mortalite operatoire de 12;63. Les meningiomes usuels de type meningothelial ont predomine (55;78). Conclusion .Les meningiomes ont represente les plus frequents des tumeurs intracraniennes en milieu ivoirien. Des etudes ulterieures africaines epidemiologiques permettront de le verifier. Les meningiomes ont ete diagnostiques chez des patients relativement plus jeunes (43 ans) que ceux des pays occidentaux (58 ans). Depuis l'avenement du scanner des services de neurochirurgie et de neuropathologie; les meningiomes ne posent moins de probleme de diagnostic. Les unites de recherche sur l'oncogenese et sur les therapeutiques complementaires a la chirurgie sont encore inexistantes

[Spinal tuberculosis. Epidemiologic and diagnostic aspects: a study of 28 clinical observations]. / La tuberculose vertébrale: aspects épidémiologiques et diagnostiques. A propos de 28 observations cliniques de Côte d'Ivoire.

OBJECTIVE: To rapidly diagnose spinal tuberculosis in order to improve its prognosis. METHODS: A retrospective study of 28 clinical observations of patients treated in the neurosurgery department of Yopougon's University Teaching Hospital during a 7-year period (January 1994-December 2000). The diagnosis of spinal tuberculosis was established based on clinical, radiological microbiological and histologic arguments. RESULTS: The mean age of the patients is 40 years (from 5 to 75 years of age). The typical spondylodiscitis was the commonest form observed (22 cases) with paravertebral abcess (4 cases). Retropharyngeal abcess was noted in two cases. One case of spondylitis was observed. In two cases, there were a spondylodiscal lesion associated with neural arch lesion. CT scan was helpful in determining the extent of the lesions whereas standard radiography was normal. CONCLUSION: The diagnosis is difficult because of the atypical form of spinal tuberculosis. These forms need differential diagnosis with spine tumors.